Kersten and Associates  900 Fort Street Mall, Suite 400, Honolulu Hawaii 96813 Phone (808)531-3137  Fax (808)261-2626  kerstenandassociates@live.com

Things to Consider

Medical Considerations

What Medicare/
Medicaid Covers

Long Term Care Costs - Hawaii

Long Term Care Costs -  National Average (PDF File)

Cost vs Benefits

Cost of Waiting

Quality of Life

Preliminary Underwriting

While there are no medical exams required to apply for Long Term Care insurance, there are issues regarding medical history and medications which need to be addressed. Generally, to qualify for Preferred rates, an individual must be in excellent overall health, a non-tobacco user for a minimum of 12 months, and must have no history of using assistive devices or medical appliances, no history of long term care services, no anticipated or recommended surgery, and height and weight within a preset range.

In each application, there are about 5 questions which must be answered "No" before the application may be completed and submitted. These may include, but not be limited to:

1.	Are you covered by Medicaid (not Medicare)?
2.	Do you need assistance or supervision by another person in performing any of the following: moving in/out of bed or chair, bathing, dressing, eating, toileting, bowel or bladder control, or walking?
3.	Have you had, do you currently have, or have you ever been medically diagnosed as having any of the following:
	AIDS AIDS Related Complex ALS (Lou Gehrig Disease) Alzeheimer's Disease Congestive Heart Failure (CHF) in combination with any of the following: Heart Attack, Angina, Emphysema/Chronic Obstructive Pulmonary Disease (COPD), Angioplasty or Heart Surgery, Asthma or Chronic Bronchitis, Diabetes or Tuberculosis (TB) Cirrhosis of the Liver	Dementia Diabetes under treatment Emphysema/COPD in combination with any of the following: current smoking, Congestive Heart Failure (CHF), Asthma, or Chronic Bronchitis Frequent or persistent forgetfulness Memory Loss Metastatic Cancer (spread) from original site/location	Multiple Sclerosis (MS) Muscular Dystrophy Organic Brain Syndrome Parkinson's Disease Positive HIV Test Senility Stroke Transient Ischemic Attack (TIA) within the past 5 years TIA in combination with Diabetes or Heart Surgery TIA two or more times
4.	In the past 6 months have you had: Open Heart Surgery; Back or Spine Surgery?
5.	In the past 4 years have you had Cancer of the: Bone, Brain, Esophagus, Liver, Ovary, Pancreas, Stomach or Intestines?

There are certain medical conditions and medications which would immediately preclude an individual from applying or being accepted for Long Term Care Insurance. Each carrier has its own underwriting guidelines and the following is intended to give you an idea of what conditions may be cause for decline:

UNINSURABLE TREATMENTS, SERVICES, DEVICES, AND APPLIANCES

TREATMENTS

DEVICES/APPLIANCES

Radiation

Respirator

Chemotherapy

Oxygen

Dialysis

Walker

Wheel Chair

SERVICES

Stair Lift

Home Health Care

Feeding Tubes

Nursing Home Care

Quad Cane

Adult Day Care

Physical Therapy

Occupational Therapy

Speech Therapy

UNINSURABLE MEDICATIONS

The following medications indicate a serious underlying condition that will generally result in a declined application. This list is not all-inclusive; each carrier has its own specific guidelines and each application will be evaluated on an individual basis. They will take into consideration diagnosis, as well as dosage, duration and frequency of use.

Adriamycin - Malignant Tumors

Alkeran - Multiple Myeloma

Aricept - Alzheimer's Disease

Artane - Parkinson's Disease

A.Z.T. - HIV, AIDS

Cogentin - Parkinson's Disease

Cognex - Alzheimer's Disease

Cyloserine - Alzheimer's Disease

Cytoxan - Malignant Tumors

D.D.I. - HIV, AIDS

Depo-Provera - Inoperable, Recurrent, and Metastatic Endometrial and Renal Carcinoma

Eldepryl - Parkinson's Disease

Estinyl - Cancer

Ergoloid - Decline in Mental Capacity

Exelon - Alzheimers Disease/Dementia

Gold Therapy - Arthritis

Haldol - Antipsychotic

Hydergine - Decline in Mental Capacity

Imuran - Immunosuppressant

Interferon - Immunosuppressant

L-Dopa - Parkinson's Disease

Larodopa - Parkinson's Disease

Leukeran - Malignant Tumors, Not Curative

Methadone - Severe pain

Morphine - Severe pain

MS Contin - Severe pain

Parlodel - Parkinson's Disease

Parsidol - Parkinson's Disease

Permax - Parkinson's Disease

Remicade - Rheumatoid Arthritis

Rezulin - Diabetes

Risperdal - Anti-Psychotic

Sinemet - Parkinson's Disease

Steroid Use - 5+ mg daily

Symmetrel - Parkinson's Disease

Zyprexa - Anti-Psychotic

If the applicant is being treated with any of the above medications for a different condition, the application should be submitted for consideration. This list is not all-inclusive.